HomeMy Public PortalAbout5827-5827 1/2-5729 TEMPLE CITY BLVD_Certificate of Occupancy__ APPLICATION FOR OCCUPANCY INSPECTION
7OR APP.,LICANT TO FILL IN '(Print or type only) COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BU,yLDINGBUILDING AND SAFETY.DIVISION
ADDRESS 582-Ph Temple City Blvd.
BUILDING
CITY Tem le Cit ZIP 9178D ADDRESS
P
SIZE OF LOT NO..OF BLDGS• LOCALITY
NOW ON LOT SQ�� 034t
NEAREST
TRACTBLOCK LOT Nb ' CROSS ST,
ASSESSOR
OWNERTEL. MAP BOOK PAGE PARCEL
Donald 'R. MCCombeSNO. 287-4242 DISTRICT TYPE I FIRE PROCE ED BY
ADDRESS 2360 Lorain Road CA I/ ZONE
CITY San Marino ZIP 911D8 USE ZONE 'MAP
SIZE OF N0. OF N0.
EXISTING BLDG. STORIES C� SP IAL
L CONDITIONS
PRESENT USE OF BUILDING BLDG. SETBACK FROM
FRONT PROP. LINE OF (STREET)
Acco'6ntinq Office HI HWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
NO. PARKING. ; FRONT PROP. LINE HIGHWAY WIDTH
SPACES PROVIDED. 6 + _
BLDG. SETBACK
REASON FOR INSPECTION REQUEST SIDE PROP. LINE OF (STREET) C
HIGHWAY + YARD = TOTAL SETBACK FR TYPE OF EXISTING
New Business SIDE PROP. LINE H Y WIDTH
t � + = d
CORNER CUTOFF YES NO L
I i
PROPOSED MAX. OCC. OCCUPANCY GROUP®
- AS VERIFIED OCCUPANT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS LOAD
APPLICATION AND STATE THAT THE ABOVE IS COR-
R ECT. EXIT HARDWARE:
NO. OF EXITS NO SPEC. KNOWL. ❑
SIGNATURE OF
PANIC DEVICES ❑
APPLICANT
PARKING REQ O ` PROVIDED O
ADDRESS 351. Cherry Drive
Pasadena CA' 91105
ZIP
W+=55.46
MAKE- CHECKS PAYABLE.TO:
HARVEY T. BRANDY COUNTY ENGINEER FINAL
DATE
APPLICATION VALIDATION CK. M.O. CASH
F'AUG 840-0 .0-0 lk.,48 i
6A662-CE992 I2=73 - - - ^